Rapid Development of Massive Tendon Xanthomas following Highly Active Antiretroviral Therapy

Letters1 October 2002Rapid Development of Massive Tendon Xanthomas following Highly Active Antiretroviral TherapyNathalie Leung, MD, Robert A. Hegele, MD, FRCPC, and Gary F. Lewis, MD, FRCPCNathalie Leung, MDUniversity Health Network; Toronto, Ontario M5G 1X8, Canada (Leung)Robarts Research Institute; London, Ontario N6A 5K8, Canada (Hegele)University Health Network; Toronto, Ontario M5G 1X8, Canada (Lewis), Robert A. Hegele, MD, FRCPCUniversity Health Network; Toronto, Ontario M5G 1X8, Canada (Leung)Robarts Research Institute; London, Ontario N6A 5K8, Canada (Hegele)University Health Network; Toronto, Ontario M5G 1X8, Canada (Lewis), and Gary F. Lewis, MD, FRCPCUniversity Health Network; Toronto, Ontario M5G 1X8, Canada (Leung)Robarts Research Institute; London, Ontario N6A 5K8, Canada (Hegele)University Health Network; Toronto, Ontario M5G 1X8, Canada (Lewis)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-137-7-200210010-00028 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Hyperlipidemia, lipodystrophy, insulin resistance, and hyperglycemia are well-described side effects of HIV treatment with highly active antiretroviral therapy (HAART) (1–3). Although substantial increases in triglyceride and cholesterol levels have been associated with HAART, there have been no reports to date of xanthomas developing after treatment with these drugs (4, 5). We describe one of the first cases of rapidly developing massive xanthomas of the tendons in a 41-year-old HIV-positive man.In our patient, lesions were first noted approximately 12 months after HAART (stavudine, 80 mg/d; lamivudine, 300 mg/d; saquinavir, 2400 mg/d; and ritonavir, 1200 mg/d) was started; ...References1. Graham NM. Metabolic disorders among HIV-infected patients treated with protease inhibitors: a review. J Acquir Immune Defic Syndr. 2000;25 Suppl 1 S4-11. [PMID: 11126425] CrossrefMedlineGoogle Scholar2. Dubé MP. Disorders of glucose metabolism in patients infected with human immunodeficiency virus. Clin Infect Dis. 2000;31:1467-75. [PMID: 11096014] CrossrefMedlineGoogle Scholar3. Thiébaut R, Daucourt V, Mercié P, Ekouévi DK, Malvy D, Morlat P, et al . Lipodystrophy, metabolic disorders, and human immunodeficiency virus infection: Aquitaine Cohort, France, 1999. Groupe d'Epidémiologie Clinique du Syndrome d'Immunodéficience Acquise en Aquitaine. Clin Infect Dis. 2000;31:1482-7. [PMID: 11096016] CrossrefMedlineGoogle Scholar4. Bonnet E, Ruidavets JB, Tuech J, Ferrières J, Collet X, Fauvel J, et al . Apoprotein c-III and E-containing lipoparticles are markedly increased in HIV-infected patients treated with protease inhibitors: association with the development of lipodystrophy. J Clin Endocrinol Metab. 2001;86:296-302. [PMID: 11232015] CrossrefMedlineGoogle Scholar5. Lenhard JM, Croom DK, Weiel JE, Winegar DA. HIV protease inhibitors stimulate hepatic triglyceride synthesis. Arterioscler Thromb Vasc Biol. 2000;20:2625-9. [PMID: 11116063] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University Health Network; Toronto, Ontario M5G 1X8, Canada (Leung)Robarts Research Institute; London, Ontario N6A 5K8, Canada (Hegele)University Health Network; Toronto, Ontario M5G 1X8, Canada (Lewis) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAn exceptional case of xanthomatous infiltration of the musculoskeletal and integumentary systemsThe Genital, Perianal and Umbilical RegionsTuberous and tendinous xanthomata secondary to ritonavir-associated hyperlipidemiaPathogenesis, detection and treatment of Achilles tendon xanthomasMusculoskeletal features of disorders of lipid metabolism and multicentric reticulohistiocytosisCurrent Awareness: Pharmacoepidemiology and Drug SafetyTwo More Drugs Associated with SIADH;Infliximab-Induced Systemic Lupus Erythematosus;Massive Tendon Xanthomas Associated with HAART;Ischemic Colitis with Sumatriptan;Fatal Hepatic Necrosis Due to Lamotrigine;Antidepressant-Induced Sexual DysfunctionAntiretrovirals 1 October 2002Volume 137, Issue 7Page: 624KeywordsApolipoproteinsCellsCholesterolHighly active antiretroviral therapyLesionsLipoproteinsLow density lipoproteinMutationPhenotypesTendons ePublished: 1 October 2002 Issue Published: 1 October 2002 Copyright & PermissionsCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...